Scholarlink

Background <p>Neuroleptic Malignant Syndrome (NMS) is an idiosyncratic and life-threatening side effect that typically occurs in response to dopamine receptor antagonist medications, such as typical and atypical antipsychotics, as well as metoclopramide. It can also result from the withdrawal of dopaminergic agents like levodopa and amantadine. Three previous case reports described the occurrence of NMS in patients with a history of benzodiazepine (BZD) withdrawal.</p> Case presentation <p>This report describes a 67-year-old female patient who was hospitalized at another hospital with a complaint of dyspepsia for a gastrointestinal work up. She had a long history of self-medicating with chlordiazepoxide (15–25&#xa0;mg/day) and propranolol (10&#xa0;mg, 2–3 times daily) for approximately 40 years due to generalized anxiety disorder and obsessive- compulsive disorder. During a psychiatric consultation, chlordiazepoxide was discontinued, and she was prescribed buspirone, citalopram and olanzapine (5&#xa0;mg at night). Subsequently, she developed fever and chills, confusion, and abdominal pain accompanied with nausea and vomiting followed by a high fever (40&#xa0;°C), muscle rigidity, tremors, autonomic instability, altered level of consciousness, leukocytosis, elevated creatine phosphokinase (3925 U/L) and ileus. She was managed under the diagnosis of Neuroleptic malignant syndrome(NMS) in another hospital.</p> Conclusions <p>Abrupt cessation of benzodiazepines (BZD) in patients with a history of long-term use may trigger catatonia, which in some cases— especially when treated with antipsychotics— can progress to NMS. Ileus, likely as an manifestation of autonomic dysfunction, may represent an under-recognized complication of this syndrome. This association remains hypothetical and requires confirmation in larger studies.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Abrupt chlordiazepoxide withdrawal as a risk factor for neuroleptic malignant syndrome with autonomic manifestation of ileus

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年9月12日

查看全文
  • Forouzan Elyasi,
  • Mehran Zarghami,
  • Sahar Faghani,
  • Arghavan Fariborzifar,
  • Alireza Nikzad-Jamnani

摘要

Background

Neuroleptic Malignant Syndrome (NMS) is an idiosyncratic and life-threatening side effect that typically occurs in response to dopamine receptor antagonist medications, such as typical and atypical antipsychotics, as well as metoclopramide. It can also result from the withdrawal of dopaminergic agents like levodopa and amantadine. Three previous case reports described the occurrence of NMS in patients with a history of benzodiazepine (BZD) withdrawal.

Case presentation

This report describes a 67-year-old female patient who was hospitalized at another hospital with a complaint of dyspepsia for a gastrointestinal work up. She had a long history of self-medicating with chlordiazepoxide (15–25 mg/day) and propranolol (10 mg, 2–3 times daily) for approximately 40 years due to generalized anxiety disorder and obsessive- compulsive disorder. During a psychiatric consultation, chlordiazepoxide was discontinued, and she was prescribed buspirone, citalopram and olanzapine (5 mg at night). Subsequently, she developed fever and chills, confusion, and abdominal pain accompanied with nausea and vomiting followed by a high fever (40 °C), muscle rigidity, tremors, autonomic instability, altered level of consciousness, leukocytosis, elevated creatine phosphokinase (3925 U/L) and ileus. She was managed under the diagnosis of Neuroleptic malignant syndrome(NMS) in another hospital.

Conclusions

Abrupt cessation of benzodiazepines (BZD) in patients with a history of long-term use may trigger catatonia, which in some cases— especially when treated with antipsychotics— can progress to NMS. Ileus, likely as an manifestation of autonomic dysfunction, may represent an under-recognized complication of this syndrome. This association remains hypothetical and requires confirmation in larger studies.